Francesca Giannone

The Specific Role of Childhood Abuse, Parental Bonding, and Family Functioning in Female Adolescents With Borderline Personality Disorder

This study examined a broad variety of adverse childhood experiences in a consecutive sample of female adolescent inpatients with borderline personality disorder (BPD; n = 44) compared with a clinical control (CC; n = 47) group with mixed psychiatric diagnoses. BPD was diagnosed using a structured clinical interview; different dimensions of childhood adversity were assessed using the Childhood Experiences of Care and Abuse Questionnaire, the Parental Bonding Instrument, and the Family Assessment Device. A history of childhood adversity was significantly more common in patients with BPD than in the CC group. Using a multivariate model, sexual abuse (OR = 13.8), general family functioning (OR = 8.9), and low maternal care (OR = 7.6) were specific and independent predictors of adolescent BPD. The results increase our knowledge of the specific role of different dimensions of childhood adversity in adolescent BPD. They have important implications for prevention and early intervention as they highlight the need for specific strategies for involving the family.

Dis-Identity: New Forms of Identity and Psychopathology—Socioanthropological Changes and Self-Development

The passage from modernity to postmodernity deeply upset the group dimension, and, consequently, personal identity itself. Transformations involving the entire planet, socioanthropological changes our society had to cope with, are producing a change in the dynamics of identity formation and the appearance of new psychopathological figures. The loss of cohesion of the sense of belonging and the weak internalization process of the elements that form the individual identity (cultural, linguistic, religious traditions, etc.) draw an essentially uncertain and temporary existence. Drawing on some themes of subjectual group analysis theory of personality, the article proposes the concept of dis-identity as key to read ongoing psychic changes.

Victims of Racket: Entrepreneurs and Traders Dealing with Cosa Nostra, ‘Ndrangheta, and Camorra

This work proposes research on a still unexplored psychical world: thoughts, emotions, and real events experienced by racket victims of the three largest criminal organizations of the South of Italy: Mafia, Camorra, and ‘Ndrangheta. The purpose is to understand the multifaceted psycho-anthropological and social issues criminal organizations have settled on, and particularly which psycho-relational dynamics and sociocultural codes come into play in the complex and controversial relationship between victim and criminal system, between victim and support systems. With entrepreneurs and tradesmen victims of organized crime, we have analyzed lived experiences—in particular fear—and psychological problems they had to cope with; events and motivations that allowed them “breaking” the silence and asking for help; the representation of a support network before and after their possible pressing charges; the kind of help offered by support systems. Dignity and self-respect, the fight for ones own freedom and honor, deep values of southern cultures, those same values the various Mafias use and radicalize, turning them upside down and transforming them into suppression and domination tools, seem to be the main themes leading the rebellion to victimization. Together with this are the strong supports of anti-racket association networks.

Environmental factors that distinguish between clinical and healthy samples with childhood experiences of abuse and neglect

Background: Childhood maltreatment is associated with a wide range of problems in adulthood. However, specific environmental factors (either positive or negative) influence mental health outcomes in maltreated children. The present study investigated the effect of environmental factors by comparing a group of clinical participants with experiences of abuse/neglect with a healthy group with similar patterns of experiences. Environmental factors selected were: separation from parents, financial hardship, parental psychiatric disorders, and low social involvement. Method: The study included 55 mixed clinical participants and 23 healthy participants. All participants were investigated using the Childhood Experience of Care and Abuse (CECA) interview. The two groups were specifically matched with regard to patterns of childhood maltreatment. Results: The findings indicated that psychopathological outcome was associated with a greater presence of negative environmental factors (p < 0.001). In particular, lack of social support seemed to be the only one predictor (OR = 27.86). Conclusion: This study is the first to investigate the influence of specific environmental factors in two groups with similar childhood experiences of abuse/neglect but different mental health outcomes. These findings suggest that efforts should be made to incorporate both familial and external sources of social support in promoting mental health for maltreated children.

Dipendenza da sostanze ed esperienze sfavorevoli infantili: uno studio empirico condotto con la Childhood Experiences of Care and Abuse Interview (CECA)

Numerose ricerche rilevano l’impatto che esperienze sfavorevoli infantili possono avere sulla dipendenza da sostanze. 32 tossicodipendenti maschi in trattamento presso comunita e 32 soggetti appartenenti a un gruppo non clinico sono stati intervistati attraverso la Childhood Experience of Care and Abuse (CECA). La maggior parte dei soggetti del gruppo clinico ha esperito maggiori esperienze (p < 0.05) di negligenza, abuso fisico e psicologico, e ha ricevuto forme piu inadeguate di supervisione e disciplina. Inoltre, i soggetti del gruppo clinico sono stati esposti a un numero piu elevato (p = 0.01) di esperienze sfavorevoli. I risultati suggeriscono la presenza di specifiche forme di abuso e maltrattamento legate allo sviluppo di dipendenza da sostanze.

Group Psychotherapy in Italy

Abstract This article describes the history and the prevailing orientations of group psychotherapy in Italy (psychoanalytically oriented, psychodrama, CBT groups) and particularly group analysis. Provided free of charge by the Italian health system, group psychotherapy is growing, but its expansion is patchy. The main pathways of Italian training in the different group psychotherapy orientations are also presented. Clinical-theoretical elaboration on self development, psychopathology related to group experiences, and the methodological attention paid to objectives and methods in different clinical groups are issues related to group therapy in Italy. Difficulties in the relationship between research and clinical practice are discussed, as well as the empirical research network that tries to bridge the gap between research and clinical work in group psychotherapy. The economic crisis in Italy has led to massive cuts in health care and to an increasing demand for some forms of psychological treatment. For these reasons, and because of its positive cost-benefit ratio, group psychotherapy is now considered an important tool in the national health care system to expand the clinical response to different forms of psychological distress.

Does Childhood Psychological Abuse Contribute to Intimate Partner Violence Victimization? An Investigation Using the Childhood Experience of Care and Abuse Interview

Although psychological abuse is recognized as a particularly insidious form of child abuse, research on the impact of this type of abuse related to intimate partner violence (IPV) is scant. This study examined the contribution of childhood psychological abuse to IPV in female victims and non-victims. Furthermore, it investigated the role of cumulative abuse in predicting IPV. The study included 38 women victims of IPV and 40 non-IPV women. All participants were investigated using the Childhood Experience of Care and Abuse Interview (CECA); the Revised Conflict Tactics Scale (CTS2) and the IPV History Interview were used to assess IPV in the last year and lifetime, respectively. Results indicated that psychological abuse was a stronger predictor of IPV than other maltreatment types. Furthermore, dose-response effects of cumulative abuse on IPV are well evidenced. Future research should continue examining impacts of psychological abuse on IPV so as to further inform clinical practice and intervention planning.

Environmental Dysfunctions, Childhood Maltreatment and Women’s Intimate Partner Violence Victimization

Childhood maltreatment is considered a crucial explanatory variable for intimate partner violence (IPV) in adulthood. However, a developmental multifactorial model for the etiology of IPV is not shared by researchers yet. This study has investigated the role of a wide range of childhood maltreatments and family and social dysfunctions in predicting IPV; furthermore, it tests a model where childhood maltreatment mediates the relationship between environmental dysfunctions and IPV. The sample included 78 women: IPV (38) and non-IPV (40). The Italian version of the Childhood Experience of Care and Abuse (CECA) Interview was used to assess the presence of adverse childhood experiences. The Revised Conflict Tactics Scale (CTS-2) and the IPV History Interview were used to assess IPV in the last year and lifetime, respectively. The results of a multivariate logistic regression model have indicated that only sexual (odds ratio [OR] = 4.24) and psychological (OR = 3.45) abuse significantly predicted IPV; with regard to association between IPV and environmental dysfunctions, only poor social support (OR = 8.91) significantly predicted IPV. The results of a mediation model have shown that childhood psychological and sexual abuse, in association with each other, partially mediate the relationship between poor social support and IPV. The findings from this study pinpoint poor social support as an important predictor of IPV so far neglected in the literature on the developmental antecedents of IPV. They also support the theoretical assumption according to which dysfunctional environmental variables and types of childhood maltreatment interacting with each other may influence development outcomes.

Rationale for the use of the CECA measures as preferred tools for research between child abuse/neglect and adult psychopathology

Background and purpose: The Cultural Formulation of Diagnosis (CFD) is a qualitative instrument in DSM-IV to describe the influence of culture on diagnostics. In ethnic minorities and refugees it is important to use this instrument in order to enhance diagnostic validity, communication and compliance. Method: A review of English and Dutch literature concerning qualitative and quantitative research of the use of the CFD in clinical practice, with special regard to the use of the CFD in refugees. Search terms: ‘‘cultural formulation’, ‘cultural assessment’, ‘cultural consultation’ and ‘cultural interview’. Results: 112 research studies and 28 case histories have been found. Only 9 qualitative and 7 quantitative studies were suitable for further analysis. The CFD was used in quite diverse populations, among them refugees. The qualitative studies propagated the use of the CFD, and recommended several improvements. The quantitative studies found difference in treatment effect and improvement of therapeutic competencies in therapists. Conclusion: The CFD is used successfully in diverse ethnic minority populations, as shown by qualitative and quantitative research. In refugees it is advisable to use the CFD, but improvements in the CFD have to be added.